Provider Demographics
NPI:1518434893
Name:DAIGLE, CECILIA ANN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CECILIA
Middle Name:ANN
Last Name:DAIGLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 RUE COLETTE
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-5628
Mailing Address - Country:US
Mailing Address - Phone:985-625-0023
Mailing Address - Fax:985-625-0022
Practice Address - Street 1:126 RUE COLETTE
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-5628
Practice Address - Country:US
Practice Address - Phone:985-625-0023
Practice Address - Fax:985-625-0022
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMFT1258106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty